Two red-state Democrats facing tough re-election races in 2018, Indiana’s Joe Donnelly and West Virginia’s Joe Manchin, have come out against such a Medicare overhaul, signaling that Republicans won’t be able to rely on bipartisan cooperation on the idea.

“They’re talking about that. This whole thing about privatization and all that -- I’m not in that camp,” Manchin told reporters Tuesday. “I’m just not there.”

Trump’s Promises

An additional complication is the president-elect’s position. Since 2015, Trump promised to be a different kind of Republican -- by protecting Medicare.

“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid. Every other Republican is going to cut,” he said in an article posted on his campaign website.

Four weeks before the election, he told a Florida crowd that Clinton “wants to cut your Medicare,” citing stolen e-mails showing her privately endorsing a bipartisan proposal that would have included long-term cuts such as raising the eligibility age.

But since his victory, Trump may be opening the door to the idea, between the Price choice and new language on his transition website that echoes proponents of privatizing Medicare. The website says Trump wants to “modernize” Medicare “so that it will be ready for the challenges with the coming retirement of the Baby Boom generation -- and beyond.”

A Trump transition-team spokesman didn’t return a request for comment.

‘Radical Departure’

Pursuing such a Medicare transformation would be “a radical departure” and “a direct violation of what Trump said” in the campaign, said Senator Sherrod Brown, an Ohio Democrat. “He’s breaking his promise. He’ll also lose.”